Diabetes drugs not widely available in developing countries

Image copyright Getty Images Image caption Many of the 46 million people in developing countries without access to modern contraceptives face unplanned pregnancies The majority of diabetes drugs approved for sale in the UK…

Diabetes drugs not widely available in developing countries

Image copyright Getty Images Image caption Many of the 46 million people in developing countries without access to modern contraceptives face unplanned pregnancies

The majority of diabetes drugs approved for sale in the UK are still not widely available in developing countries – and the pharmaceutical company that makes them is aiming to fix that.

Merck & Co has made a recommendation to the UK Medicines and Healthcare products Regulatory Agency (MHRA) to standardise its requirements for medicines in the developing world.

It said it wanted to help people in the poorest countries.

Poor people who are sexually active in many countries, and countries in sub-Saharan Africa in particular, are often unable to access sexual health drugs.

The company that makes a leading female birth control pill, Pfizer, has faced repeated calls to lower the price of its medication in countries where the medicine is not available in a pill form.

Accessing drugs

There are currently at least six non-pill forms of hormonal contraceptives available for global sale, which can be made and dispensed in the developing world.

There are several contraceptives that enable women to have larger families with fewer children and are popular with women in poor countries.

They include Norplant, a tiny metal coil with a special thin cable that makes it easier to insert than inserting a conventional coil.

A high dose of Yaz, an oral contraceptive from Bayer, has been the subject of a large study which has suggested it reduces unwanted pregnancy. However, it has not been approved for sale in many places.

Maribeth Lucier from Reproductive Health New Zealand said developing countries could not even afford to buy medicines and because of price-discounting schemes, the pills were the only way women had affordable access to them.

She said: “Each of these routes, Norplant, Yaz and Depo-Provera, can cost up to $600 a year, which is far too high a price for women living in the poorest countries in the world to be able to afford.”

Gender inequality

But she said that excluding these types of treatment was “ultimately undermining women’s health”.

Rebecca Campbell from the international development organisation World Vision said contraceptives were important because they could cut the number of unplanned pregnancies in poor countries.

“Failing to use contraceptives could lead to more than $20bn in early pregnancies and complications for women and their families, which can lead to child abuse, malaria, HIV, and other health risks,” she said.

Dr Paul Chan, from the university’s International Women’s Health Coalition, said: “Discriminatory barriers to access to contraceptive drugs and services in the developing world are a huge burden on millions of women.

“Access to even the most basic contraception is a basic right. There is no justification for developing countries to justify these barriers for poor women by saying they are not legally and morally available.

“More can be done to ensure that reproductive health services, including contraceptives, are both accessible and affordable.”

Accessibility issues

The MHRA has said it would carefully review Merck’s report and give a final response at an appropriate future date.

Merck has said that all of its medicines for the treatment of diabetes are available and easy to access at pharmacies in the UK.

In the countries where its medicines are already available, it said it would work with clinicians and pharmacists to make sure that people are aware of their availability, and the price of its diabetes drugs.

It also wants to work more closely with WHO and GAVI to ensure that access to condoms is well developed, and ideally reach those who need them.

An MHRA spokesperson said: “The Medicines and Healthcare Products Regulatory Agency (MHRA) recommends an appropriate test for the effectiveness of a generic medicine that would allow it to be prescribed by GPs, pharmacist or both in both registered and unregistered setting.

“The MHRA, as part of a routine clinical assessment of this generic, considered that the recommended test might be clinically appropriate in the Indian market for certain therapeutic formulations of the treatment of diabetes.”

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